Saturday, August 8, 2009

On Health Care Reform in the United States

As a Canadian citizen, I'm a big fan of universal health care. I've been to hospitals all over the country - in both cities and towns - and I've also received medical treatment in New York. For the most part I've found Canadian hospitals to be cleaner, faster, and friendlier than hospitals in the States, even though they're run by the state. Of course, one could say that's simply subjective, but when it comes to public service, public opinion is everything.

That said, not everyone is happy with Northern health care. Many Canadians are upset about the lengthy wait times in hospitals, shortage of doctors, and waiting lists for surgeries that come with socialized medicine. Though I have not personally encountered any of these problems, they do exist and have pursuaded some Canadians that universal health care isn't worth the trouble. However, for the most part, Canadians are more satisfied with their health care, even though wait times may be longer. A survey done by the New England Journal of Medicine on wait times for orthopedic surgery has shown that while the average wait time for initial consultation was two weeks for Americans and four weeks for Canadians, more Canadians seemed happy with their wait times than Americans. They also found that wait times for surgeries were not nearly as long as some might have expected. You can read more about that here.

While Canadians won't deny that the biggest problems with our health care are the chronic wait times, universal medicine is still considered one of the greatest things to ever to happen to Canada. It is generally the case that the only people to dispute this fact are only the ones who can afford otherwise. As a country, however, it seems like universal health care is the best fiscal decision. Even though Canada's universal health care is often declaimed by American conservatives as a drain on our finances, a recent article in the NYTimes Econimix blog says otherwise. While Americans currently paying 16% of their GDP on health care, Canadians are only paying about 10%, and our life expectancy continues to be higher. Most Canadians who are dissatisfied with their health care, although constituting a minority, seem to agree that a two tier system is best, guaranteeing health care for all while giving an option for extra, private benefits that may lead to quicker access for those who are willing to pay for it. This seems to be exactly what the Obama-Biden plan is proposing.

According to the plan, "The Obama-Biden plan both builds on and improves our current insurance system, which most Americans continue to rely upon, and leaves Medicare intact for older and disabled Americans." In addition, the Government plans to guarantee eligibility for those with pre-existing conditions, who would be otherwise unable to purchase health insurance, to create a National Health Insurance Exchange to help Americans purchase private health insurance or enroll in the new public plan. The plan will also work to end the monopoly on insurance and drug companies and allow for more competition in these fields. You can read more about thathere.

Now, I understand the tendency of the American people to be wary of government involvement in health care. The federal government doesn't have a great track record with social programming. Since it decided to become involved in the education system, the quality of America's public education has drastically declined. In 2002 Congressman Dr. Ron Paul wrote that, “Fifty years ago, before the federal government became involved in public education, American grammar and high schools were the best in the world. […] The stark contrast between our public schools then and now shows that federal control of education has failed.” The "bureaucratic black hole" which Dr. Paul claims is the federal government's involvement in education is quite possibly the same one which a government-run health care reform system would fall into. However, the Obama-Biden plan has an interesting escape hatch for states unhappy with the new system. According to the plan, "states can continue to experiment, provided they meet the minimum standards of the national plan." Rather than closing the door to individual state-run health care, the federal government plans to encourage the states to experiment and improve upon the federal plan, provided they meet the basic federal expectations.

One must also note that the proposed federal plan advocates publicly funded access to health care, rather than publicly run health care. The government cannot and will not deny anyone health care, nor deny them access to private services of any sort. The plan promises only to subsidize and make readily available access to health care that does not currently exist, providing not the health care itself, but rather the means to receive it. When republicans like Sarah Palin claim that the plan waves itself in the face of human dignity and is a danger to the lives of innocent children, they demonstrate a dire misunderstanding of the plan, especially the portion which requires all children to have health care coverage.

To speak about basic human dignity and then to deny even the possibility of universal health care is absolutely ridiculous. Ms.Palin claims that "government health care will not reduce the cost; it will simply refuse to pay the cost." This seems rather unlikely, given that the government already spends approximately 16% percent of the annual GDP on health care, and these massive reforms are only estimated to cost around $120 billion of America's $48,000 per capita GDP, or 0.8%. Moreover, the disease prevention programs included in the plan are likely to reduce health care costs over the next few years. Not a huge increase, given the positive consequences.

All of this considered, I for one am a strong advocate for the Obama-Biden plan, as long as measures are in place to ensure that it doesn't become the bureaucratic black hole that the education system has. Since it seems that they are, I am simply happy that all of my American friends will finally be able to enjoy living without the financial stress of getting sick. I believe that by allowing private companies the same place in health care they always have while providing a public alternate and by promoting competition to improve the quality of medicine, the Obama-Biden plan will improve health care for everyone.